'When you hear hoofbeats, think of horses not zebras' - the old adage is well-known to GPs but what should you do when faced with a zebra, not a horse? Consultant cardiologist Professor Robert Tulloh and GP Dr Louise Tulloh kick off our new series with their advice on how to catch Kawasaki disease in general practice.

Sainsbury's to open up to 200 GP franchises

Exclusive: Supermarket giant Sainsbury's plans to roll out up to 200 in-store GP franchises in a move that will dramatically ramp up the role of the private sector in primary care.

The company has already begun approaching GPs to run surgeries alongside dentists and other health services in what it calls in-store polyclinics, claiming patients want more of the NHS under one roof.

Stores in London and Leeds are among those earmarked for the first wave of Sainsbury's-branded GP services, in a move causing some GP leaders to voice ‘huge ethical concerns'.

Dr Mohammed Jiva, secretary of Heywood, Middleton and Rochdale LMC and the GP who opened a pioneering Sainsbury's surgery in Manchester a year ago, has been given a pivotal role in the plan. His company PriMed Services will be charged with vetting applicants from across the country to award franchises to GPs.

Under the terms, GPs could run extended hours or in-hours services – or even locate entire branch surgeries – at more than a quarter of the 785 Sainsbury's stores.

NHS services would be funded by PCTs and available for patients on the lists of participating practices, and GPs would also be able to carry out private work at the stores to boost their income.

Since last March, Dr Jiva has employed three other local practices alongside his own to offer PCT-funded extended hours surgeries at Heaton Park Sainsbury's, which has also launched podiatry and dental services and has plans for chiropody and physiotherapy.

He said: ‘We've done more than 1,500 consultations and haven't had one complaint.'

Dr Jiva added: ‘We've been talking already in London and Leeds about the first franchises. Patients will be able to get a full health MOT at Sainsbury's, while the stores get the footfall and increased sales.'

He said a major incentive for him was that he could be paid for his extended hours work without any superannuation deductions as the income comes via his private company.

Dr Jiva said GPs would be offered three-year contracts, paying his firm £100 per month and rent to Sainsbury's of around £10 an hour.

Franchise-holding GPs would then negotiate NHS funding with their PCT.

A Sainsbury's spokesperson said: ‘We're very confident these services will be popular with customers who appreciate the convenience of having services under one roof. We've done a lot of preparation.'

The scheme comes as Sainsbury's also won a contract to host a GP-led health centre in Chelmsford, which is being developed in partnership with Mid Essex PCT.

But the prospect of hundreds of GPs donning Sainsbury's name badges has split GP leaders.

GPC negotiator Dr Beth McCarron-Nash said: ‘I have concerns if the relationship of trust is unduly influenced by commercialism. Patients may be bombarded with information they would not usually receive in the health arena. I have huge concerns about the ethical dilemma faced by doctors.'

But Dr Richard Vautrey, deputy GPC chair and a GP in Leeds, said: ‘If it's basically a branch surgery it should be treated like any other branch surgery.'

Dr Budgie Savage, a GP in Lambeth, south London, said her practice had been approached by Sainsbury's but had declined the offer because of objections to the role of the private sector in the NHS.

Supermarket chain Sainsbury's is to open 200 GP franchises Supermarket chain Sainsbury's is to open 200 GP franchises